Radiology Trainee Performance in Digital Breast Tomosynthesis: Relationship Between Difficulty and Error-Making Patterns

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• 作者：Lars J. Grimm ; MD ; MHS^a ; ^{lars.grimm@duke.edu" class="auth_mail" title="E-mail the corresponding author} ; Jing Zhang ; PhD^a ; ^b ; Joseph Y. Lo ; PhD^a ; ^c ; ^d ; Karen S. Johnson ; MD^a ; Sujata V. Ghate ; MD^a ; Ruth Walsh ; MD^a ; Maciej A. Mazurowski ; PhD^a ; ^c
• 关键词：tomosynthesis ; error-making patterns ; difficulty ; breast cancer ; residents
• 刊名：Journal of the American College of Radiology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：13
• 期：2
• 页码：198-202
• 全文大小：370 K

文摘

The aim of this study was to better understand the relationship between digital breast tomosynthesis (DBT) difficulty and radiology trainee performance.

Methods

Twenty-seven radiology residents and fellows and three expert breast imagers reviewed 60 DBT studies consisting of unilateral craniocaudal and medial lateral oblique views. Trainees had no prior DBT experience. All readers provided difficulty ratings and final BI-RADS^® scores. Expert breast imager consensus interpretations were used to determine the ground truth. Trainee sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated for low- and high-difficulty subsets of cases as assessed by each trainee him or herself (self-assessed difficulty) and consensus expert-assessed difficulty.

Results

For self-assessed difficulty, the trainee AUC was 0.696 for high-difficulty and 0.704 for low-difficulty cases (P = .753). Trainee sensitivity was 0.776 for high-difficulty and 0.538 for low-difficulty cases (P < .001). Trainee specificity was 0.558 for high-difficulty and 0.810 for low-difficulty cases (P < .001). For expert-assessed difficulty, the trainee AUC was 0.645 for high-difficulty and 0.816 for low-difficulty cases (P < .001). Trainee sensitivity was 0.612 for high-difficulty and .784 for low-difficulty cases (P < .001). Trainee specificity was 0.654 for high-difficulty and 0.765 for low-difficulty cases (P = .021).

Conclusions

Cases deemed difficult by experts were associated with decreases in trainee AUC, sensitivity, and specificity. In contrast, for self-assessed more difficult cases, the trainee AUC was unchanged because of increased sensitivity and compensatory decreased specificity. Educators should incorporate these findings when developing educational materials to teach interpretation of DBT.